What's Next Health:Jammed Up: Is Too Much Choice Bad for Our Health?

Each month, What’s Next Health talks with leading thinkers about the future of health and health care. Recently, we talked with Sheena Iyengar, Inaugural S.T. Lee Professor of Business at Columbia University, about navigating the thousands of choices we make daily – and the stress that comes with making so many decisions. In this post, RWJF Director Lori Melichar reflects on Sheena's visit to the Foundation.

Each of us makes choices constantly and those choices reverberate across other aspects of our lives. By choosing to read this blog, you’ve chosen to place something else on hold.

Depending on the time of day you read this, you have likely made hundreds of distinct choices today...from choosing to hit snooze one...or two, or three times, to choosing what to eat for breakfast, where to park and whether to take the stairs or the elevator in your office or home.

I don't have to tell you that so many of the choices you have made in the last 24 hours already will affect your health, your bodies (those of you who had green smoothies for breakfast are probably feeling a little better than those who, like me, had a muffin), as well as your mental health (how many of you, like me, are regretting your decision to stay up to watch another episode of The Americans instead of getting eight hours of sleep?). Many of the choices you make are simple, but many are extremely complex.

The emerging science that helps us understand why we make the choices we do—and how to influence those choices—is equally complex.

Recently, we had one of the country’s leading experts on choice visit us for a day as part of our What’s Next Health series.

Dr. Sheena Iyengar is the inaugural S.T. Lee Professor of Business at Columbia Business School. Through reading her book, The Art of Choosing, and spending the day with her at the Foundation, she challenged many of my preconceived notions about choice, specifically how choice impacts our health.

Sheena asks and answers fascinating questions – Is the desire for choice innate or created by culture? How much control do we really have over our choices? And how much control do we want—or should we have over our choices?

In fact, she asks so many good questions, that it was really difficult for me to choose a focus for this blog post!

So maybe I’ll procrastinate with lunch... a peanut butter and jelly sandwich....what could be simpler than that?

The picture above is from a mid-morning snack buffet I encountered at a recent conference. It was early in the day, but I already had a lot on my mind – How should I spend the break time? Emailing? Calling the office? Networking? Exercising? Figuring out elementary “afterschool” activities for my kids for next fall?

Taking a snack break did not make things easier. Though I entered the line having made the decision of what I wanted for a snack (peanut butter and jelly), now I was being asked to make two more decisions. What kind of jelly? What kind of peanut butter?

Some of you are familiar with the concept of decision fatigue—when the number and/or complexity of the decisions you make earlier in a day affect the quality of the decisions you make later in the day.

Here, I was being asked to allocate precious bandwidth to the activity of selecting between mango passion fruit and strawberry jam, and between almond cashew butter and coffee pecan butter? Are you kidding me?

My look of bewilderment and frustration caught the attention of the woman manning the station. With a knowing nod, she made a simple suggestion: “You’ll like the almond cashew butter.”

A wave of relief came over me. There was no reason for me to think that this woman had any idea what I would like or what I would prefer. But I followed her advice—skipping the jelly all together. I got my sandwich and got on with my life, on to more consequential decisions.

So is decision fatigue inevitable? If so, what does this mean for our health?

Sheena suggests that fatigue does not have to be a fait accompli for busy days. In fact, many times it is not in our own best interest for us to make the decisions that affect our lives—ourselves. For one, we often make the wrong decision. But even in cases where we ended up making the RIGHT choice, the stress of the decision may not be worth the control we experienced.

In one of her studies, she examined the role of choice in retirement accounts. When people were given more choices of funds to invest in they actually either opted to participate less (meaning they didn’t save at all) or they just opted to put all their eggs in one basket in the form of money market funds (a less than ideal selection). So in this case, it was clear that more choice was adverse in making better choices.

We often talk about making the healthy choice the easy choice. But rarely do we talk about how to make the act of choosing easier. How can we help take choices off someone’s plate? When can we take them off our own? How do we better time our choices so they don’t fall victim to decision fatigue? And when does too much choice ironically become unhealthy?

And when it comes to decisions about our health, is more choice always healthier? Choice and information is certainly empowering but, despite the best of intentions, can it sometimes become paralyzing?

I’m going to ask you to decide.

Watch the video below with Lori Melichar and Sheena Iyengar and view an infographic about the art of choosing.

This commentary originally appeared on the RWJF Pioneering Ideas blog.

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